Saturday, November 04, 2006

New Studies, Health News, and Your Government in Action

Danish study finds HPV test better that Pap for women >40yo. The study is: Kjaer S, Hogdall E, Frederiksen K, Munk C, van den Brule A, Svare E, Meijer C, Lorincz A, Iftner T. The absolute risk of cervical abnormalities in high-risk human papillomavirus positive, cytologically normal women over a 10-year period. Cancer Res. 2006 Nov 1;66(21):10630-6. [Abstract] This prospective cohort study was conducted in ~10,000 Danish women who were available for both initial examination and follow-up examination via Pap test and cervical swab for HPV detection. The women were divided into two groups, the younger group (n=7,219) and the older group (n=2,200). Denmark has a personal identification system and pathology data bank that allowed the researchers to track cervical cytology in the study population. From the authors:"Results from this prospective cohort study with a long-term follow-up of women from the general population through the routine screening system showed that among women 40 to 50 years old, who were cytologically negative with a concurrent positive HPV DNA test (high-risk types), nearly 25% developed cytologic abnormalities (atypia) within 5 years, and after 10 years, more than 35% had had an abnormal Pap test. These risk estimates were higher than those observed among women with both negative cytology and negative HPV DNA test (high-risk types), which were as low as 4% and 10% after 5 and 10 years, respectively. Also among younger HPV-positive women (22-32 years old at enrollment), we found a high absolute risk of subsequent cervical abnormalities (atypia), 18% after 5 years and 24% after 10 years, and a low risk among HPV-negative women, 5% after 5 years."

Federal Guidelines Expand Scope of Abstinence Education Funds To Include People up to Age 29 - "According to Wade Horn, HHS assistant secretary for children and families, the revised guidelines for 2007 are aimed at people ages 19 to 29 because recent data show that more unmarried women in that age group are having children." The program in question requires that contraception not be discussed, and the teaching that sex within marriage is the expected behavior. Is it really the best idea public health-wise to try to keep 20-somethings (i.e., adults) ignorant about contraception and infection-prevention? Is a 29-year-old woman having a child outside of marriage really among the important things we're facing as a nation? Does it really promote the general welfare? Or is it just about the [perceived] ickiness of adult women having sex and sexual freedom, and making their own life-choices?

Our government wants to make it more difficult for the U.S.-born children (i.e., citizens) of immigrants to get healthcare, by requiring further proof of citizenship before receiving Medicaid. Critics think the parents may be reluctant to jump through the hoops for fear of deportation. This seems like the time to introduce my device for remembering which is Medicaid and Medicare: "We aid the poor, but we care for the elderly."